Individual
IMARA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3707 SUNSET LN, ANTIOCH, CA 94509-6101
(925) 522-0124
Mailing address
3707 SUNSET LN, ANTIOCH, CA 94509-6101
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN262449
CA
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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